Microperimetry to predict disease progression in eyes at high risk of age‐related macular degeneration disease: The PREVISION study

Abstract

Purpose The aim of the present study was to determine whether microperimetric parameters could predict the progression of an eye at high risk of age‐related macular degeneration (AMD) at 24 months. Methods We conducted a multicentric prospective non‐comparative open‐label study including patients with one eye in stage 4 of the Age‐Related Eye Disease Study Group (AREDS) classification, and the other eye in AREDS stage 3 (study eye). A microperimetry examination (MAIA™, CenterVue, Padova, Italy) was performed at baseline and every 6 months during the 2‐year follow‐up. At the end of the follow‐up, each study eye was classified as ‘progressive’ (i.e. AREDS stage 4) or ‘non‐progressive’ (i.e. AREDS stage 3). Results A total of 147 patients were analysed, of which 30.6% progressed from AREDS stage 3 to stage 4. The microperimetry criterion ‘mean retinal sensitivity’ was significantly different at baseline between non‐progressive and progressive eyes (p = 0.022), with lower values for the latter. With a threshold for mean retinal sensitivity set at 24.7 dB, diagnostic sensitivity was 80% [95%CI (65.4–90.4)], specificity was 30.4% [95%CI (21.7–40.3)], positive predictive value was 33.6% [95%CI (24.8–43.4)], and negative predictive value was 77.5% [95%CI (61.5–89.2)]. In the multivariate analysis including microperimetric parameters and other routine ophthalmologic examinations, mean retinal sensitivity was the only predictive parameter statistically associated with progression (p = 0.0004). Conclusions Our findings are encouraging as regards the use of microperimetry, and mean retinal sensitivity value in particular, to predict the 2‐year risk of progression to AREDS stage 4 eye.

Efficacy οf Wet Age-related Macular Degeneration Treatment οn Reading: A Pilot Study Using Eye-movement Analysis

“…7,48,49 Similarly, in these cases, visual acuity, which evaluates foveal integrity, may not be indicative of the functional impairment of the affected eye. Microperimetry 50,51 and functional tests, that is, contrast sensitivity or retinal sensitivity, 49,52 which also consider the slow information transfer rate in AMD patients, 41 may provide complementary end points of macular visual function and progression of the disease. 7 Finally, functional reading was not assessed using formally standardized passages, such as the International Reading Speed Texts, which are now available in Greek.…”